Immunizations for Staff and Children

Contagious diseases still spread in Ontario, though some can be prevented with vaccines. For child care registrants and/or employees who choose to delay or not vaccinate, there are some important responsibilities to consider:

Diseases can spread even when others are not showing symptoms.
Identify early signs and symptoms of diseases to know when to seek immediate medical assistance.
In the event of a contagious disease at the child care centre, the child or staff may need to go home to prevent the spread of disease.
Follow recommended isolation procedures to protect other children, especially infants, young children, pregnant individuals and staff with poor immune systems.
When visiting a doctor, emergency room or medical clinic, let the medical staff know that the person is not vaccinated. This may assist the doctor to consider the possibility of vaccine preventable diseases. Medical clinics may also need to take precautions to prevent the spread of disease to others.
Advise pregnant staff and parents/caregivers to talk to their doctor about the risks and other ways to protect themselves and their baby from vaccine preventable diseases (e.g., whooping cough, congenital rubella).

Immunization Requirements for Children

Children attending a child care centre should receive vaccines according to their age under the Ontario's Publicly Funded Immunization Schedule .

The Child Care and Early Years Act (CCEYA), Section 35 (1) of O. Reg. 137/2015 (General) requires child care centre operators to collect registrant’s immunization information or a valid exemption before admission to the centre.

Child care centres are not required to keep immunization records or exemptions of grade-school children (e.g., kids in before or after-school programs).

Where to Find Your Child’s Vaccine Documentation

In Ontario, the yellow vaccine card is usually given to you after getting vaccines at the health care provider’s office. Parents who cannot locate their child’s immunization record can check with their provider.

Foreign Records

TPH receives vaccination information in many languages other than English. TPH will offer translation services for school-age children. For children that are not school aged, TPH recommends finding a settlement agency or community agency that offer translation services.

Childhood Vaccines-Quick Reference Guide

Learn more about the required vaccines (or to have a valid exemption) for children who attend childcare and school.

Immunization Requirements for Staff

Before commencing employment, child care centre staff are required to be vaccinated according to the recommendation made by the local medical officer of health (under Section 57 (1), O. Reg. 137/2015). Toronto’s Medical Officer of Health’s vaccine recommendations for staff of child care centres are listed below.

The operator must collect and maintain the information on file at the facility. Toronto Public Health requires all employees to have up-to-date immunization as listed below. Students and volunteers are also recommended to receive these vaccines for their personal protection. Staff, students and volunteers should see their health care provider to determine their immunization status and to obtain any missing vaccines.

Vaccine	Description	Recommendations for Staff and Documentation Required *
Hepatitis B vaccine	Persons with hepatitis B may not show symptoms but can spread the virus through body fluids. For personal protection, all staff should be vaccinated.	Documented 2-4 dose series (as a child or adult) or Proof of Immunity Some may have received this vaccine in infancy, or as a combination vaccine for travel – e.g., Twinrix®
Measles, Mumps, Rubella (MMR) vaccine	Measles is very contagious and can spread through the air even after the infectious person has left the room.	Documented 2 doses or Proof of immunity (if born in 1970 or earlier or blood tests)
Diphtheria, Tetanus, Pertussis (Tdap) vaccine	Tetanus is naturally occurring in the soil. Pertussis, also called the "100 day cough" is very dangerous to young infants.	Documented one dose of Tdap as an adult then Td vaccine booster every 10 years.
Varicella (chickenpox) vaccine	Chickenpox can spread through the air, days before the rash is present. It can lead to severe complications.	Documented 2 doses given at least 6 weeks apart or Proof of immunity (self-reported history of chickenpox or a blood test)
Seasonal Influenza vaccine	Staff working with children under 5 years of age are strongly encouraged to receive this vaccine each year.	Annual vaccination. No documentation required.
COVID-19 vaccine	Staff working with children under 5 years of age are strongly encouraged to receive this vaccine each year.	Annual vaccination. No documentation required.

*Or a valid exemption (see below)

Immunization Exemptions

Parents who choose not to have their child vaccinated or staff who choose not to be vaccinated may be exempted from vaccination under the CCEYA for medical reasons or due to religious or philosophical reasons

For Medical reasons:

The parent or staff will follow up with their Health Care Practitioner (HCP). The HCP will complete the Statement of Medical Exemption-Childcare and Early Years Act.
Parent or staff will then submit the form back to their daycare centre.

For Religious or philosophical reasons:

The parent or staff completes the CCEYA Statement of Conscience or Religious Belief
Parent or staff will then submit the form back to their daycare centre.

The CCEYA Statement of Conscience or Religious Belief form is valid until the child enters junior kindergarten after it is notarized, and an exemption is noted in your child’s vaccination record. If parents still wish to have a valid non-medical exemption on their child’s immunization record, parents will need to complete the process for non-medical exemption for school-age children which falls under the Immunization of School Pupils Act.

Completed exemption forms are to be kept in the child’s or employee’s file.

In the event of an outbreak or case of a vaccine preventable disease (e.g., measles), children and staff who are not immunized may be excluded from the child care centre. This is to minimize the risk of spreading the disease.

Ontario Exemption Forms

Statement of Medical Exemption form, must be completed by a legally qualified medical practitioner.
Statement of Conscience or Religious Belief Affidavit form, must be notarized by a Commissioner of Oaths.

Information on Downloading the Forms

You must download the free Adobe Acrobat Reader (version 10.0 or above) to view/print PDF forms.

If encountering a problem opening the PDF in your browser (e.g. Chrome or Firefox), please follow these steps to open and complete the form:

Highlight the form on the Repository, right-click to select “Save link as” to save the PDF form onto the desktop. Do not double-click the form and open it in a browser.
Open the form that you saved on the desktop with Adobe Reader. Do not double-click to open the PDF form as Adobe Reader might not be the default program to open PDFs on your computer.
Now complete the form, save the data, and close it. Then open again to see if the input data is there.

More information can be found by visiting Ontario Central Forms Repository.